• Logo
  • SBMUJournals

Discriminatory precision of renal angina index in prediction of acute kidney injury in children: a systematic review and meta-analysis

Arash Abbasi, Pardis Mehdipour Rabori, Ramtin Farajollahi, Kosar Mohammad Ali, Nematollah Ataei, Mahmoud Yousefifard, Mostafa Hosseini
50

Views


Abstract

Introduction: There is still controversy over the value of renal angina index (RAI) in predicting acute renal failure (AKI) in children. Therefore, the present study aims to provide evidence by conducting a systematic review and meta-analysis on the value of RAI in this regard.

Methods: An extensive search of Medline, Embase, Scopus and Web of Science databases was conducted by the end of January 2020 using words related to RAI and AKI. Two independent reviewers screened and summarized the related studies. Data were analysed using STATA 14.0 statistical program and discriminatory precision of RAI was assessed.

Results: Data from 11 studies were included. These studies included data from 3701 children (60.41% boys). There were 752 children with AKI and 2949 non-AKI children. Pooled analysis showed that the area under the ROC curve of RAI in prediction of AKI was 0.88 [95% confidence interval (CI): 0.85 to 0.91]. Sensitivity and specificity of this tool in predicting AKI were 0.85% (95% CI: 0.74% to 0.92%) and 0.79% (95% CI: 0.69% to 0.89%), respectively. The diagnostic odds ratio of RAI was 20.40 (95% CI: 9.62 to 43.25).

Conclusion: The findings of the present meta-analysis showed that RAI is a reliable tool in predicting AKI in children.


Keywords

Acute Kidney Injuries; Renal Insufficiency; Severity of Illness Index; Child

References

Schneider J, Khemani R, Grushkin C, Bart R. Serum creatinine as stratified in the RIFLE score for acute kidney injury is associated with mortality and length of stay for children in the pediatric intensive care unit. Critical care medicine. 2010;38(3):933-9.

Goldstein SL, Devarajan P. Pediatrics: Acute kidney injury leads to pediatric patient mortality. Nature reviews Nephrology. 2010;6(7):393-4.

Murray PT, Devarajan P, Levey AS, Eckardt KU, Bonventre JV, Lombardi R, et al. A framework and key research questions in AKI diagnosis and staging in different environments. Clinical journal of the American Society of Nephrology : CJASN. 2008;3(3):864-8.

Devarajan P. Update on mechanisms of ischemic acute kidney injury. Journal of the American Society of Nephrology : JASN. 2006;17(6):1503-20.

Nickolas TL, Barasch J, Devarajan P. Biomarkers in acute and chronic kidney disease. Current opinion in nephrology and hypertension. 2008;17(2):127-32.

Devarajan P. Review: neutrophil gelatinase-associated lipocalin: a troponin-like biomarker for human acute kidney injury. Nephrology (Carlton, Vic). 2010;15(4):419-28.

Coca SG, Yalavarthy R, Concato J, Parikh CR. Biomarkers for the diagnosis and risk stratification of acute kidney injury: a systematic review. Kidney international. 2008;73(9):1008-16.

Coca SG, Parikh CR. Urinary biomarkers for acute kidney injury: perspectives on translation. Clinical journal of the American Society of Nephrology : CJASN. 2008;3(2):481-90.

Basu RK, Zappitelli M, Brunner L, Wang Y, Wong HR, Chawla LS, et al. Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children. Kidney international. 2014;85(3):659-67.

Basu RK, Wang Y, Wong HR, Chawla LS, Wheeler DS, Goldstein SL. Incorporation of biomarkers with the renal angina index for prediction of severe AKI in critically ill children. Clinical Journal of the American Society of Nephrology. 2014;9(4):654-62.

Menon S, Goldstein SL, Mottes T, Fei L, Kaddourah A, Terrell T, et al. Urinary biomarker incorporation into the renal angina index early in intensive care unit admission optimizes acute kidney injury prediction in critically ill children: a prospective cohort study. Nephrology dialysis transplantation. 2016;31(4):586-94.

Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology. JAMA: the journal of the American Medical Association. 2000;283(15):2008-12.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of internal medicine. 2009;151(4):264-9.

Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Annals of internal medicine. 2011;155(8):529-36.

Basu RK, Zappitelli M, Brunner L, Wang Y, Wong HR, Chawla LS, et al. Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children. Kidney international. 2014;85(3):659-67.

Basu RK, Kaddourah A, Goldstein SL, Akcan-Arikan A, Arnold M, Cruz C, et al. Assessment of a renal angina index for prediction of severe acute kidney injury in critically ill children: a multicentre, multinational, prospective observational study. The Lancet Child and Adolescent Health. 2018;2(2):112-20.

Gawadia J, Mishra K, Kumar M, Saikia D. Prediction of Severe Acute Kidney Injury using Renal Angina Index in a Pediatric Intensive Care Unit. Indian Pediatrics. 2019;56(8):647-52.

Hanson HR, Carlisle MA, Bensman RS, Byczkowski T, Depinet H, Terrell TC, et al. Early prediction of pediatric acute kidney injury from the emergency department: A pilot study. American Journal of Emergency Medicine. 2020:[In press].

Kaur R, Dhooria GS, Pooni PA, Bhat D, Bhargava S, Kakkar S, et al. Utilization of the renal angina index in PICU of a developing country for prediction of subsequent severe acute kidney injury. Pediatric nephrology (Berlin, Germany). 2018;33(11):2185-91.

Menon S, Goldstein SL, Mottes T, Fei L, Kaddourah A, Terrell T, et al. Urinary biomarker incorporation into the renal angina index early in intensive care unit admission optimizes acute kidney injury prediction in critically ill children: a prospective cohort study. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 2016;31(4):586-94.

MA. P, F. A. Diagnostic Accuracy of Renal Angina Index in Predicting Acute Kidney Injury in Pediatric Patients with Sepsis: A Philippine Tertiary Hospital Experience. Pediatric Infectious Disease Society of the Philippines Journal. 2018;19(1):32-9.

Sethi SK, Raghunathan V, Shah S, Dhaliwal M, Jha P, Kumar M, et al. Fluid Overload and Renal Angina Index at Admission Are Associated With Worse Outcomes in Critically Ill Children. Frontiers in Pediatrics. 2018;6:7.

Sundararaju S, Sinha A, Hari P, Lodha R, Bagga A. Renal angina index in the prediction of acute kidney injury in critically ill children. Asian Journal of Pediatric Nephrology. 2019;2(1):25-31.

Youssef D, Mansour S, El_shal A, Osman A, Yousif Y, Arab F, et al. Renal angina validation of acute kidney injury in critically ill children. GEGET. 2019;14(2):47-53.

Zeid AMA, Mohammed DY. Urinary NGAL incorporation into Renal Angina Index for early detection of acute kidney injury in critically ill children. J Clini Nephrol. 2019;3:93-9.

de Melo Bezerra Cavalcante CT, Castelo Branco KM, Pinto Junior VC, Meneses GC, de Oliveira Neves FM, de Souza NM, et al. Syndecan-1 improves severe acute kidney injury prediction after pediatric cardiac surgery. The Journal of thoracic and cardiovascular surgery. 2016;152(1):178-86.e2.

Basu RK, Wang Y, Wong HR, Chawla LS, Wheeler DS, Goldstein SL. Incorporation of biomarkers with the renal angina index for prediction of severe AKI in critically ill children. Clinical journal of the American Society of Nephrology : CJASN. 2014;9(4):654-62.




DOI: https://doi.org/10.22037/aaem.v8i1.585

DOI (PDF): https://doi.org/10.22037/aaem.v8i1.585.g757

DOI (HTML): https://doi.org/10.22037/aaem.v8i1.585.g786